ACS CPG Notes Flashcards
(27 cards)
What is the primary goal of prehospital STEMI management?
Rapid identification of STEMI to facilitate timely reperfusion (PCI or PHT).
What antiplatelet therapy is provided?
Aspirin.
How do we reduce cardiac workload?
By treating associated symptoms such as nausea and pain.
What conditions fall under the ACS spectrum?
• Unstable angina
• NSTEACS
• STEMI
Do all ACS patients present with chest pain?
No – especially not elderly, females, or those with diabetes or atypical presentations.
Does a normal ECG rule out AMI?
No. Serial ECGs, serial enzyme tests, and history are needed.
Should spontaneously resolved ACS pain be ignored?
No – it still warrants hospital investigation.
What should be considered before performing invasive procedures in thrombolysis-eligible patients?
Risk of increased bleeding.
Should oxygen be routinely administered in ACS?
No. Only administer per CPG A0001 Oxygen Therapy.
If a patient received <300 mg aspirin prior to AV arrival, what should you do?
Top up the dose to as close to 300 mg as possible.
Why are nitrates contraindicated in bradycardia?
Because HR < 50 bpm means patient can’t compensate for decreased venous return → ↓ cardiac output.
What formula explains cardiac output?
C.O. = HR × SV (Cardiac Output = Heart Rate × Stroke Volume).
If GTN S/L isn’t possible, what’s an alternative route?
Buccal administration.
What’s the goal of analgesia in ACS?
To make the patient comfortable – not necessarily completely pain-free.
When is aggressive opioid use not ideal in ACS?
When excessive doses are required to make patient pain-free – it can be detrimental.
How is nausea/vomiting managed in ACS?
As per CPG A0701 Nausea and Vomiting.
How is left ventricular failure (LVF) managed?
As per CPG A0406 Acute Pulmonary Oedema.
How is inadequate perfusion managed?
As per CPG A0407 Inadequate Perfusion.
Where do you find guidance for dysrhythmias in ACS?
In the appropriate dysrhythmia CPG.
When might chest pain occur after Pfizer/Moderna vaccine?
1–10 days post-vaccine.
What group is most affected?
Males aged 12–29 years.
How long does post-vaccine chest pain usually last?
24–48 hours, self-resolving.
Is severe myocarditis common after mRNA vaccines?
No, it’s very rare, but serious causes should be excluded.
What symptoms warrant emergency care post-vaccine?
ECG changes or other concerning features (e.g., PE or MI).
